Frankly Speaking About Family Medicine

Fluoride in Drinking Water: Why Is There Controversy? - Frankly Speaking Ep 419

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419
Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children’s IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic.
Episode resource links:
Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025. 
Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856. 
Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976
Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

My Tummy Hurts—Reasonable Options for Fluid Replacement in Mildly Dehydrated Children - Frankly Speaking Ep 418

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-418
Overview: Acute episodes of nausea, vomiting, and diarrhea due to gastroenteritis in children are common complaints seen in primary and urgent care settings. Join us as we discuss recent evidence suggesting that apple juice can be as effective as commercial electrolyte solutions, offering a cost-effective and convenient option for oral replacement therapy for mild dehydration.
Episode resource links:
Freedman SB, Willan AR, Boutis K, Schuh S. Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial. JAMA. 2016;315(18):1966-1974. doi:10.1001/jama.2016.5352
Goldman RD, Friedman JN, Parkin PC. Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics. 2008;122(3):545-549. doi:10.1542/peds.2007-3141
Jauregui J, Nelson D, Choo E, et al. External validation and comparison of three pediatric clinical dehydration scales. PLoS One. 2014;9(5):e95739. Published 2014 May 2. doi:10.1371/journal.pone.0095739
https://primarycarenotebook.com/pages/haematology/world-health-organization-who-scale-for-dehydration
AAP: Signs of Dehydration in infant and children
https://primarycarenotebook.com/pages/haematology/world-health-organization-who-scale-for-dehydration
Guest: Susan Feeney, DNP, FNP-BC, NP-C 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

A Matter of the Heart—Screening Guidelines for Cardiovascular Disease - Frankly Speaking Ep 417

Credits: 0.25 AMA PRA Category 1 Credit™
 
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-417
 
Overview: Joseph is a 57 year old male who presents today for his routine annual exam. He is a healthy male, who is active and has no complaints today. He reports that since he was seen last he generally has been doing well but did have a ER visit for persistent cough in the setting of recovering from Covid. While in the Emergency Department he did undergo testing. On a CT Chest scan there was an incidental finding of moderate coronary artery calcifications.  He asked today, what does moderate coronary artery calcification? Is my heart ok, my dad had a heart attack at 60. 
 
Episode resource links:
https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke#:~:text=Heart%20disease%20and%20stroke%20can,and%20high%20cholesterol%20through%20treatment.
Vikulova, D. N., Lee, M. K., Humphries, K. H., Pinheiro-Muller, D., Dawes, M., Pimstone, S. N., & Brunham, L. R. (2024). Preventive Lipid-Lowering Therapy and Interactions With Health Care in Patients Who Develop Premature Coronary Artery Disease. JACC: Advances, 101316.
 
Maron, D. J., Budoff, M. J., Sky, J. C., Bommer, W. J., Epstein, S. D., Fisher, D. A., ... & DeMaria, A. N. (2024). Coronary Artery Calcium Staging to Guide Preventive Interventions: A Proposal and Call to Action. JACC: Advances, 3(11), 101287.
https://www.cdc.gov/heart-disease-family-history/about/index.html
 
Guest: Mariyan L. Montaque, DNP, FNP-BC
 
Music Credit: Matthew Bugos
 
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 

My Back Still Hurts! Nonpharmacologic Approaches to Chronic Back Pain - Frankly Speaking Ep 416

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-416
Overview: Listen in as we discuss chronic sacroiliac (SI) dysfunction and the role of nonpharmacological therapies, including acupuncture, in managing back pain and improving function. Hear evidence-based considerations for integrating acupuncture into your practice to offer effective, medication-free options for patients with chronic SI pain.
Episode resource links:
Kim G, Kim D, Moon H, et al. Acupuncture and Acupoints for Low Back Pain: Systematic Review and Meta-Analysis. Am J Chin Med. 2023;51(2):223-247. doi:10.1142/S0192415X23500131
Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. 2020;12(12):CD013814. Published 2020 Dec 11. doi:10.1002/14651858.CD013814
Tu J-F et al. Acupuncture vs sham acupuncture for chronic sciatica from herniated disk: A randomized clinical trial. JAMA Intern Med 2024 Oct 14; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5463)
Wu M, Fan C, Liu H, et al. The Effectiveness of Acupuncture for Low Back Pain: An Umbrella Review and Meta-Analysis. Am J Chin Med. 2024;52(4):905-923. doi:10.1142/S0192415X2450037X https://www-dynamed-com.umassmed.idm.oclc.org/condition/sciatica
Guest: Susan Feeney, DNP, FNP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

It’s Time to Equip Patients with PEP - Frankly Speaking Ep 415

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-415
Overview: Join us as we discuss the role of postexposure prophylaxis (PEP) in reducing the incidence and adverse outcomes of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. Discover when, why, and how to prescribe PEP to better provide your patients with effective prevention options to help reduce rising STI rates and disproportionate impacts on women.
Episode resource links:
Stewart, J., Oware, K., Donnell, D., Violette, L. R., Odoyo, J., Soge, O. O., ... & Baeten, J. M. (2023). Doxycycline prophylaxis to prevent sexually transmitted infections in women. New England Journal of Medicine, 389(25), 2331-2340.
https://www.cdc.gov/sti/php/from-the-director/doxy-pep-sti-prevention-strategy.html#:~:text=Doxy%20PEP%20has%20proven%20to,syphilis%2C%20chlamydia%2C%20gonorrhea).
Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

Is Standing Better than Sitting for Decreasing Cardiovascular Risk? - Frankly Speaking Ep 414

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-414
Overview: Standing desks are a popular choice for people with sedentary jobs who want to increase their physical activity. In this episode, we look at the latest data on the benefits and risks of prolonged standing and provide actionable strategies to help patients reduce cardiovascular risk through informed movement choices.
Episode resource links:
Ahmadi MN, Coenen P, Straker L, Stamatakis E. Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence. Int J Epidemiol. 2024 Oct 13;53(6):dyae136. doi: 10.1093/ije/dyae136. PMID: 39412356; PMCID: PMC11481281.
Guest: Alan M. Ehrlich, MD, FAAFP 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

A Vitamin for Skin Cancer Prevention? - Frankly Speaking Ep 413

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-413
Overview: Listen in to learn about the role of nicotinamide (vitamin B3) in reducing the risk of certain skin cancers. This episode reviews key prevention strategies, the latest evidence on skin cancer management, and practical approaches to support patients with sun-damaged skin.
Episode resource links:
Discuss the prevalence of basal cell and squamous cell carcinomas 
Review the potential benefits of nicotinamide (vitamin B3) for the prevention of skin abnormalities
Identify additional methods to prevent skin cancer
Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

Positioning is Everything for Accurate BPs! - Frankly Speaking Ep 412

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-412
Overview: Discover how improper arm positioning can lead to inaccurate blood pressure readings and influence hypertension management as we discuss a recent randomized controlled trial. Hear evidence-based techniques to ensure proper arm and cuff positioning, improving hypertension diagnosis in your clinical practice.
Episode resource links:
JAMA Intern Med. Published online October 7, 2024. doi:10.1001/jamainternmed.2024.5213
Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
 

Don’t Miss the Red Flags for Early-Onset Colorectal Cancer - Frankly Speaking Ep 411

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-411
Overview: This episode focuses on the rising prevalence of early-onset colorectal cancer and its critical indicators. Learn to recognize key symptoms, ensure timely diagnostic workups, and effectively address red flags to prevent delayed diagnosis.
Episode resource links:
Demb, J., Kolb, J. M., Dounel, J., Fritz, C. D. L., Advani, S. M., Cao, Y., Coppernoll-Blach, P., Dwyer, A. J., Perea, J., Heskett, K. M., Holowatyj, A. N., Lieu, C. H., Singh, S., Spaander, M. C. W., Vuik, F. E. R., & Gupta, S. (2024). Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA network open, 7(5), e2413157. https://doi.org/10.1001/jamanetworkopen.2024.13157
US Preventive Services Task Force Screening Guidelines for Colorectal Cancer: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
American Cancer Society Infographic for Patients:  Colorectal Cancer:  Catching it Early https://www.cancer.org/cancer/types/colon-rectal-cancer/prevention-infographic.html
Gómez-Molina R, Suárez M, Martínez R, Chilet M, Bauça JM, Mateo J. Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review. Healthcare. 2024; 12(16):1645. https://doi.org/10.3390/healthcare12161645
Guest: Jill M. Terrien PhD, ANP-BC 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
 

To D or Not to D? New Guidance on Vitamin Supplementation - Frankly Speaking Ep 410

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-410
Overview: In this episode, we discuss the latest updates on vitamin D. Learn about its link to common disorders, when to consider supplementation, and what the most recent practice guideline says about vitamin D and disease prevention—empowering you to make informed decisions and improve patient care without unnecessary screenings or treatments.
Episode resource links:
Marie B Demay, Anastassios G Pittas, Daniel D Bikle, Dima L Diab, Mairead E Kiely, Marise Lazaretti-Castro, Paul Lips, Deborah M Mitchell, M Hassan Murad, Shelley Powers, Sudhaker D Rao, Robert Scragg, John A Tayek, Amy M Valent, Judith M E Walsh, Christopher R McCartney, Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 109, Issue 8, August 2024, Pages 1907–1947, https://doi.org/10.1210/clinem/dgae290
Michael F. Holick, Neil C. Binkley, Heike A. Bischoff-Ferrari, Catherine M. Gordon, David A. Hanley, Robert P. Heaney, M. Hassan Murad, Connie M. Weaver, Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 7, 1 July 2011, Pages 1911–1930, https://doi.org/10.1210/jc.2011-0385
Guest: Jillian Joseph, PA-C Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com